Two local hospitals fined over care lapses

Online: To read about the 13 hospital fines announced yesterday by the state, go to cdph.ca.gov

One San Diego hospital used a faulty respirator on a brain-injured man and another left a sponge inside a spinal-surgery patient, triggering the state's maximum penalty for mistakes that could cause death or serious injury.

California's health regulators yesterday said Scripps Mercy Hospital and the University of California San Diego Medical Center, both in Hillcrest, were hit with $25,000 fines. The state Department of Public Health assessed the same fines against 11 other hospitals for “immediate jeopardy” incidents, which are critical lapses in care that could have been prevented.

This was the second citation for Scripps Mercy and UCSD since the state started assessing such penalties and making them public in 2007. One of the goals is to push hospitals to do more to avoid major errors.

The punishment system was considered cutting-edge at the time. Regulators trumpet the citations during news conferences and post details of the hospitals' failures on the public health department's Web site.

Since then, hospitals across the country have faced rising pressure to boost the quality of care from a widening range of sources.

“This is a movement that has a lot of traction,” said Dr. Heidi Wald, a professor at the University of Colorado Denver's Division of Health Care Policy Research. “Congress is interested. State legislatures are interested. The public is interested.”

Medicare, typically the largest source of hospital revenue, and several private health plans have pegged future payment levels to quality assessments and refused to pay for medical care resulting from certain hospital mistakes.

Additionally, more than 25 states, including California, have passed laws requiring hospitals to report infections acquired within their walls.

“We believe that public reporting will help make patient care safer,” Emerson said. “But people need to understand that health care is delivered by humans. Inherently, there will always be opportunities for errors.”

Some safety experts have suggested that hospitals take lessons from other high-risk industries, such as airlines and nuclear power plants, which use redundant quality-control systems to minimize potentially tragic mistakes.

Hospitals that receive fines under California's penalty system probably aren't losing much business from being singled out for errors, said Nathan Kaufman, a health industry consultant in San Diego.

Surveys have shown that most people choose hospitals based on where their doctors practice and how close the facilities are to their homes, he said.

Still, hospital administrators dread the negative attention that comes from landing on a list such as the one put out periodically by the state's public health department, Wald said.

“They have reputations that they like to protect,” she said. “Everyone wants to be on the best-hospitals lists.”

In the Scripps Mercy case, the facility was cited after its staff used a faulty respirator on a 37-year-old man, according to a state investigation.

The patient was originally brought to the hospital Aug. 21 because of a severe brain injury that limited his movement and comprehension. After the man spent 12 days in the intensive-care unit, doctors ordered an MRI scan and used drugs to induce temporary paralysis for the session.